addiction – The Recovering Urchin

Radical Honesty

I recently finished a book called “Dopamine Nation” (Anna Lembke). She is a physician therapist who treats people in recovery from several addictions (including alcohol, drugs, gambling, shopping, pornography). She writes about the neurotransmitter dopamine, and how it is involved in the pain/pleasure experience. She describes how dopamine is involved in the addiction process.

One of the later chapters in her book is titled “Radical Honesty”. She notes that addictions are often associated with dishonesty, and that a path to recovery should involve honesty. Even Radical Honesty.

In AA meetings, we often read a section from the book Alcoholics Anonymous called “How It Works”. In that reading, the word “honest” appears three times in the first 100 words. I think the AA founders understood how important honesty was, even in the 1930s.

I recognize that I was dishonest during my alcoholism and addiction. I have worked hard to own my dishonesty, and the consequences of that dishonesty, by working the 12 Steps.

I don’t claim to be radically honest. I think I am improving. I do have blind spots, and I am never certain that I am even being honest with myself. So sometimes I turn to other people and ask “how am I doing?”

*****

We have an expression in the rooms, “you are only as sick as your secrets”. Secrets are a way to be dishonest. So I aim for no secrets. The opposite of secrets is transparency. If I let you into my life, into all parts of my life, maybe you will see something about me that I don’t see about myself.

I aim for transparency in three areas: money, location and schedules. Mrs. Urchin and I share the following with each other:

Money: we share all of our financial information and transactions with each other.

Location: we share our locations with each other in real time.

Schedules: we share our schedules with each other.

*****

I hope this helps.

With Love,
The Recovering Urchin

The Opioid Epidemic

I wrote this essay about the opioid epidemic in 2017. It is as true now as when I wrote it

A month ago, my father texted me and asked “what is an opioid?” I don’t usually pick up the phone when he texts me, but this time I did. He said that he was watching a documentary on the opioid epidemic, and the documentary never defined what an opioid is.

You probably know this, but just in case — “opioid” and “opiate” are used interchangeably, and describe a class of drugs that were originally derived from opium, which is extracted from the poppy plant. Examples of drugs in this class include opium, morphine, codeine, heroin, fentanyl, carfentanil, hydrocodone and oxycodone.

Opioids are very potent pain relievers. Unfortunately, they are highly addictive, because they can also be enormously pleasurable when first taken.

The New York Times published an article recently on drug overdose deaths. Check it out at this link:

Drug Deaths in America Are Rising Faster Than Ever

The New York Times estimated that 59,000-65,000 Americans died of overdose deaths in 2016. In one chart, they compare that rate to the peak fatality rates for car accidents, shootings and deaths from HIV. All of those rates are lower than the current rate of overdose deaths.

If an airliner with 180 people crashed today, killing everyone on board, within an hour every network would have special programming about it. You would know the name of the airline, the flight number, and details about all of the passengers.

An airliner full of Americans dies every day from drug overdoses, and no network is breaking into their regular programming about it.

There are a many reasons for the increase in overdose deaths in America. One is that prescription pain medication has become much more potent, and much more available. Several years ago, a new oral agent (oxycodone, marketed as Oxycontin), was approved for marketing. This drug has become widely available not only for prescription use, but also for abuse.

At the same time, the supply of heroin has increased and the cost has decreased. Heroin is now much more available, much more widely used, and less expensive than when I was growing up. Supposedly, the cost of a dose of heroin is now less than the cost of a bottle of beer. When I was in high school, the “gateway drugs” were marijuana and alcohol. Not now.

One other reason is that other very potent drugs (fentanyl and carfentanil) are being sold as heroin. Fentanyl is more potent than heroin, and carfentanil is said to be 1000-5000 times more potent than heroin.

If someone thinks that they are injecting heroin, but receives either fentanyl or carfentanil, they are going to die.

The opioid epidemic is not some far-away problem that only happens in a newspaper. It is a local problem that is killing people who live near me. Drug overdoses now look like this in my area:

Last week, two men died of heroin overdoses not too far from where I live. What made their overdoses even more remarkable was that they were house managers in a local halfway house. They were the ones in charge of oversight at their facility.

The same week, 8 addicts died of overdoses in another small town not too far from where I live.

A recent local high school graduate died of an opiate overdose a few weeks ago.

A Philadelphia Inquirer article noted that Philadelphia had 900 fatal overdoses in 2016. Bucks County had 185. The same article included an old estimate of 10 fatal overdoses a day in Pennsylvania- and then noted that that estimate might be low now.

10 people lose their lives every day in my state from a preventable problem. And either we have become used to it, or we don’t know about it.

This is a complicated problem with no easy answers. It would be intellectually lazy to say “just cut off the supply”. The supply is not just illegal drugs like heroin. It also includes prescription drugs that are diverted. The problem is not just at our borders — it is also in our doctor’s offices and our pharmacies and our own medicine cabinets.

I read that the United States consumes 80% of the world supply of opiates. We have 4% of the world population. There is something wrong with that.

Fortunately there is hope. Treatment exists. I know two young men who recently were in treatment for opioid addiction, and both are now in recovery. But every day that they remain in recovery, almost 200 Americans are going to die from drug overdoses.

And I don’t know what to do about that.

With Love,
The Recovering Urchin

Physical Pain And Spiritual Pain

Sometimes I make a sound when I’m surprised, that sounds like “huh”.

I passed a billboard on the Pennsylvania Turnpike recently. “152 Montgomery County residents died of drug overdoses last year.

I made a sound of “huh”.

More Americans died of drug overdoses in 2015 than from car accidents. And a lot of Americans died in car accidents last year.

While I didn’t know any of the 152 people who overdosed and died last year in Montgomery County, I know several people who have died as a result of overdoses in Chester County, and Philadelphia County.

Pharmacists. Professional people. Family people. People like you and me.

Opiates are a class of pain medication that includes morphine, codeine, oxycodone, hydrocodone, and others. Some are available by prescription, and some (like heroin) are available illegally. They are very effective, and very potent, relievers of physical pain.

If I remember my pharmacy school classes well (there is no guarantee of that…), opiates bind at the mu receptor in the central nervous system to create the effect of analgesia. In other words, they block pain by interacting at a cellular level. The effect is so pleasurable that some users want to re-create the experience over and over again.

Opiates can be very addictive.

I just finished reading an article about an epidemic of fentanyl use in Canada.

According to the article, fentanyl (an opiate 100x more potent than morphine) is widely available, and can be ordered online. It is being mass-produced overseas, and shipped directly to the homes of Canadian addicts.

In the United States, we have the same problem with oxycodone. American users purchase prescription opiates online (or on the street, or with a physician’s prescription).

Some municipalities have taken to providing an opiate antidote, naloxone, to those who request it. The antidote is highly effective if it is administered quickly to someone who is experiencing an opiate overdose.

While I support this measure, it really only scratches the surface of the problem.

Providing naloxone to those who are overdosing will save some people from overdosing. But it won’t decrease the supply of opiates, and it won’t decrease the demand for them, either.

The “war on drugs” didn’t decrease the demand for drugs, and it didn’t decrease the supply of drugs, either. It just created a much larger prison system. We have way more people imprisoned in 2016 for drug offenses than we did in 1980, and more drug use too.

The supply of drugs isn’t going to go away. In the article I read about Canada’s

fentanyl problem, the authors described the economics of drug distribution. A user can purchase $10,000 worth of raw fentanyl powder, tablet filling supplies, and a tablet press, and sell the end product for as much as $2,000,000 worth of fentanyl tablets.

That is a 200x profit. As long as 200-fold profits are available, someone will be willing to sell drugs, regardless of the consequences.

The drug epidemic is a problem that doesn’t have an easy answer. I wish it did. So what follows are not suggested solutions. They are some of my thoughts about the problem:

What if the problem isn’t about drugs? The kinds of drugs we are dealing with existed 50 years ago. Some of the drugs are new, but they are really new variations of older drugs. What if the drug epidemic is a symptom of something else?

What if the problem is with us? What if we changed? Suppose the problem is that we seek temporary comfort from permanent problems?

What if the type of pain that we are trying to medicate isn’t physical pain? What if the type of pain our society is trying to medicate is spiritual pain? What if opiates can’t scratch the kind of itch that we have?

I don’t like to ask these questions. I would much rather stick my head in the sand and hope that the problem goes away.

But no matter how much I stick my fingers in my ears and say “na na na na I can’t hear you!”, the reality is still there. Right in front of me on a billboard on the Pennsylvania Turnpike.

With Love,
The Recovering Urchin

Guest post: Addiction and spirituality

President Trump has declared the opioid epidemic a national health emergency, addiction experts compare it with the AIDS epidemic, educators grapple with drugs in schools, and parents lie awake at night dreading a 3:00 a.m. phone call.

Still, the body count rises. There were more than 63,000 drug-related deaths in 2016, up 21 percent from the year before and the biggest one-year rise in three decades.

This may be an opportune time to pause, step back and ask whether we are fully utilizing all the tools at our disposal.

David H. Rosmarin, an assistant professor at Harvard Medical School and the director of the Spirituality and Mental Health Program at McLean Hospital in Belmont, Mass, posits that spirituality may be one such instrument.

In a December 2017 Wall Street Journal article, Mr. Rosmarin wrote that in his first six months as a pre-doctoral psychology intern at McLean Hospital, he was approached by at least 10 patients asking to discuss their problems not in psychological terms but in spiritual ones.

Mr. Rosmarin is not a theologian. He is a practicing Orthodox Jew and clinical scientist. He smilingly credits his yarmulke with conferring an air of authenticity.

Although rarely mentioned in thousands of media reports about the current opioid crisis, the idea of a nexus between spirituality and psychiatry is not new.

Carl Jung called alcoholism “a spiritual thirst …. for wholeness: the union with God.”

In 1950 Jung wrote that a “nodding acquaintance with the theory and pathology of neurosis is totally inadequate, because medical knowledge of this kind is merely information about an illness, but not knowledge of the soul that is ill.”

A crusty former addict of my acquaintance declares that the next doctor who claims to have cured an addict will be the first. He concedes that addicts suffer severe mental distress (“dis-ease”), but favors “soul sickness” to disease.

A prominent local psychiatrist, now deceased, working in the addiction field once confided to me that the medical profession “knows (nothing) about addiction.”

The issue then is whether education, therapy, treatment, needle exchanges, Narcan and the rest merely treat the symptoms of the “dis-ease” while the “soul that is ill” inexorably sinks deeper into John Bunyan’s “slough of despond.”

Mr. Rosmarin cites a 2014 study which concluded that “religion and spirituality have the ability to promote, or damage, mental health.” It urged “an increased awareness of religious matters by practitioners in the mental health field as well as ongoing attention in psychiatric research.”

A 2015 review examining over 3000 scholarly articles for the International Journal of Emergency Mental Health and Human Resilience found a “positive effect” of religion/spirituality on a variety of health outcomes, including: “……lower rates of suicide, less use, abuse, and substance dependence (emphasis added), greater well-being, and reported happiness.”

The hope, meaning, purpose and connection to the divine that a spiritual life provides apparently can serve as a resource to cope with the mental distress that triggers flight into addiction.

McLean Hospital asks incoming psychiatric patients if they wish to discuss spirituality. If yes, they are then asked how is their spirituality relevant to their symptoms and treatment and ‘the conversation typically takes off from there.”.

When nothing is working, what have we got to lose?

This article was written by a friend of the Urchin who practices law, and has a long-term interest in the legal and scientific study and treatment of substance abusers and substance abuse issues. He is a regular contributor to articles pertaining to these topics.

With Love,
The Recovering Urchin

This Is Our Plague

Suppose I told you that a lot of people were dying from something and most people didn’t know it?

Suppose I told you that a shockingly high number of people were dying from a disease, and most people had no idea?

Suppose I told you that more Americans died last year from this epidemic than died in any single war we’ve ever fought? Would you be surprised?

I saw an article in my news feed recently that noted that 632,000 Americans died last year from tobacco, alcohol and drug addictions. The data was compiled by the Centers for Disease Control. I have attached links to the CDC report at the bottom of this page.

632,000 deaths a year in the U.S. Think about that. By comparison, the most Americans who died in any war was the Civil War, where 620,000 died. Those 620,000 who died in the Civil War died over the course of four years (April 1861-May 1865).

About 1,264,000 Americans have died in all wars combined.

What this means is that every year, more Americans die from addictions than died in the entire Civil War. Every two years, we lose as many Americans to addictions as we have lost in all of our wars.

That is appalling.

The World Health Organization just released a report entitled “Global Status Report on Alcohol and Health 2018”. In the report, they estimate that 3 million people died worldwide in 2016 from alcohol abuse.

Three million.

In 2017, Alcoholics Anonymous estimated its total membership at just under 2.1 million people.

That means that more people (many more) are dying every year, than are members of AA.

Whatever we are doing isn’t working. Whatever we are doing isn’t enough. It isn’t enough for the 3 million people who died of alcohol abuse last year.

I will continue to do everything that I can to spread the news that there is a solution available for those who want help and are willing to work for it.

The Recovering Urchin

CDC references

https://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm

https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm

https://www.cdc.gov/media/releases/2018/p0329-drug-overdose-deaths.html

WHO reference page XV

http://apps.who.int/iris/bitstream/handle/10665/274603/9789241565639-eng.pdf?ua=1

AA Membership

Click to access smf-132_en.pdf

Guest post: The Opioid Crisis—Personal Responsibility, Choice, and the Law

In Commonwealth v. Eldred, an underreported July 16 case with nationwide implications, where addiction was an underlying issue in a criminal case, the Massachusetts Supreme Judicial Court ruled that it was not cruel and unusual punishment to put a person who is on probation in jail after one positive test for drugs.

Less than two weeks after a court ordered Julie Eldred to not use drugs while on probation, she tested positive for the opioid fentanyl. Consequently, Ms. Eldred, a chronic substance abuser, spent about 10 days in jail until an inpatient treatment bed was available.

In the subsequent appeal, Lisa Newman-Polk, Ms. Eldred’s attorney, argued that incarceration was unconstitutional cruel and unusual punishment because Ms. Eldred’s substance abuse disorder made her incapable of remaining drug free.

Newman-Polk, a certified social worker with clinical experience treating addiction, called the decision a “massive blow” that would place the court “on the wrong side of history.”

The court did not agree. Nor do I. To the contrary, adoption of Miss Eldred’s disease theory would dangerously undermine America’s efforts to combat its metastasizing opioid epidemic, almost certainly lead to increased drug related deaths, increased risks to public safety, increased recidivism, longer prison sentences for addicts without the possibility of probation or parole, fewer options like drug courts to incentivize recovery, and millions of new dollars invested in unproven community drug treatment programs.

Most important, it would remove an addict’s personal responsibility in the recovery process, the sine qua non of successful recovery.

According to the Diagnostic and Statistical Manual of Mental Disorders, substance abuse disorder (SUD) occurs when a person’s use of drugs or alcohol leads to health issues or problems at work, school, or home. Relapse is often a part of the recovery process.

But not everyone agrees with the disease model.

The court cited the Commonwealth’s behavioral model which postulates that SUD may affect an individual’s urge to use substances, but it does not render that individual without the free will to use substances.

The majority ultimately concluded that the defendant’s claim of SUD rested “on science that is not tested.”

Justice David J. Lowry, writing for the majority, emphasized that a defendant who violates probation is not being punished for the violation (drug use), but “anew on his [or her] underlying conviction.” The court recognized that “addiction is a status that may not be criminalized.”

Continuing, the requirement of remaining drug free is not, as Ms. Eldred contends, “an outdated moral judgment about an individual’s addiction. Rather…. the requirement is based on the (sentencing) judge’s consideration of the defendant’s circumstances and that she committed the underlying crime to support her drug use.”

Having worked with many addicts for many years, I can attest that many former users credit a stint in jail (or the mere threat) for jump starting their recovery.

Justice Lowry’s well-reasoned opinion will help protect defendants by giving them clear motivation to remain substance-free while providing for the protection of the public.

Ironically, should she remain clean and sober, Ms. Eldred may one day thank the sentencing judge for saving her life.

With Love,

The Recovering Urchin

Welcome to The Recovering Urchin!

Welcome to The Recovering Urchin. This is a website for recovering alcoholics and addicts, and people who love us.

I am a recovering alcoholic and addict. I have been sober for 36 years (as of November 2026), and I believe that my experience, strength and hope can benefit others, and hopefully help someone recover from alcoholism/addiction. I will share my story sometime soon, in a post on this website.

You are probably wondering “why use The Recovering Urchin as a website name?” Good question. Some of the answer has to do with AA’s Traditions, and some of it has to do with me.

AA’s Eleventh Tradition notes that “we need always maintain personal anonymity at the level of press, radio and films”. That was published in 1950, and it is as true today as it was when it was written. When it was written, there was no internet. Had the internet existed in 1950, the Eleventh Tradition would state “at the level of press, radio, films and the Internet”. An A.A. Guideline on the Internet notes that “the internet, social media, and all forms of public communications are implicit in the last phrase of the short form of Tradition Eleven, which reads “at the level of press, radio and films””. The Guideline later notes that we should avoid using our full name, or full-face photographs.

So you won’t see my full name or my photograph on this site. Because of the need for anonymity at the level of the Internet, I am using a pseudonym on this website: The Recovering Urchin. I am in recovery (36 years as of November 2026), and I refer to people as “urchins”. I don’t know why, but I do. I refer to my children as “the little urchins”, my wife as “Mrs. Urchin”.

I am the Recovering Urchin.

I promise you a few things about this website. First, I will remain anonymous. Second, I will not share any of your personal information with anyone, ever.

If I share parts of any of your stories (I am considering some guest blogs) I will either use only your first name, or a pseudonym.

I will try to write something recovery-related to you, about once a week. I may miss a few weeks for travel or work, but I will try.

I promise that all of the content on this site will be free.

There will not be a “Comments” section on this site, because I do not want to monitor the Comments section for trolls. I did that on another site, and it wasn’t any fun. So no Comments section.

I will try to share my experience, strength and hope with you, as it pertains to alcoholism and addiction. My hope is that my experience may benefit someone that I may never meet.

I will try to follow the Twelve Steps and Twelve Traditions on this website to the best of my ability. Some of my recovering friends have promised to check on me, and let me know how I am doing. I will try to be free of resentment, fear, and ego on this site, unless I am sharing an experience where those topics are warranted.

I wish you peace in sobriety.

With Love,
The Recovering Urchin